摘要
目的观察索磷布韦/维帕他韦单用或联合利巴韦林方案对我国基因3B型HCV/HIV感染者的治疗效果和安全性。方法选取2017年1月—2020年12月于昆明市第三人民医院就诊的3B型HCV/HIV合并感染者299例,使用索磷布韦/维帕他韦单用或联合利巴韦林治疗12周,停药后随访12周。评估治疗结束后12周的持续病毒学应答率(SVR12)和不良反应。计量资料两组间比较采用成组t检验或Mann-Whitney U检验。计数资料两组间比较采用χ^(2)检验。使用Agresti-Coull方法构建SVR12的95%CI。采用单因素和多因素非条件Logistic回归分析SVR的影响因素。结果299例3B型HCV/HIV感染者患者的平均年龄为(43.92±6.84)岁,男性占77.3%(231/299),肝硬化患者占36.5%(109/299),曾接受过抗病毒治疗者占13.4%(40/299),索磷布韦/维帕他韦联合利巴韦林治疗患者占27.8%(83/299)。患者总体SVR12为87.0%(260/299),其中索磷布韦/维帕他韦单用与联用利巴韦林SVR12比较,差异无统计学意义(87.5%vs 85.5%,χ^(2)=0.203,P=0.653);无肝硬化和肝硬化患者SVR12比较,差异有统计学意义(90.0%vs 81.7%,χ^(2)=4.256,P=0.039);抗病毒初治患者的SVR12明显高于经治患者(93.4%vs 45.0%,χ^(2)=71.670,P<0.001)。单因素和多因素Logistic回归分析结果显示,PLT(OR=0.957,95%CI:0.931~0.984,P=0.002)、肝硬度值(OR=1.446,95%CI:1.147~1.822,P=0.002)和经治(OR=13.807,95%CI:2.970~64.174,P=0.001)是3B型HCV/HIV感染者SVR的独立影响因素。出现严重不良反应事件41例,均在抗病毒治疗后2周内出现,28例在没有停药并积极处理后缓解;13例积极处理后仍未缓解,停用抗病毒药物2~5 d后缓解,缓解后再次使用未出现类似反应。结论索磷布韦/维帕他韦单用或联合利巴韦林对3B型HCV/HIV感染者有较好的治疗效果和安全性。
Objective To investigate the efficacy and safety of sofosbuvir/velpatasvir alone or in combination with ribavirin in Chinese patients with genotype 3B HCV/HIV infection.Methods A total of 299 patients with genotype 3B HCV/HIV infection who attended The Third People’s Hospital of Kunming from January 2017 to December 2020 were enrolled and treated with sofosbuvir/velpatasvir alone or in combination with ribavirin for 12 weeks,and they were followed up for 12 weeks after drug withdrawal.The patients were evaluated in terms of sustained virologic response at 12 weeks after treatment(SVR12)and adverse reactions.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups;the Agresti-Coull method was used to evaluate the 95%confidence interval(CI)of SVR12;univariate and multivariate non-conditional logistic regression analyses were used to investigate the influencing factors for SVR.Results The 299 patients with genotype 3B HCV/HIV infection had a mean age of 43.92±6.84 years,among whom the male patients accounted for 77.3%(231/299),the patients with liver cirrhosis accounted for 36.5%(109/299),the patients with a history of antiviral therapy accounted for 13.4%(40/299),and the patients receiving sofosbuvir/velpatasvir combined with ribavirin accounted for 27.8%(83/299).The overall SVR was 87.0%(260/299)for all patients,and there was no significant difference in SVR12 between the patients receiving sofosbuvir/velpatasvir alone and those receiving sofosbuvir/velpatasvir combined with ribavirin(87.5%vs 85.5%,χ^(2)=0.203,P=0.653).There was a significant difference in SVR12 between the patients without liver cirrhosis and those with liver cirrhosis(90.0%vs 81.7%,χ^(2)=4.256,P=0.039),and the patients receiving antiviral therapy for the first time had a significantly higher SVR12 than the treatment-experienced patients(93.4%vs 45.0%,χ^(2)=71.670,P<0.001).The univariate and m
作者
刘立
常丽仙
陈智勇
李俊义
刘春云
LIU Li;CHANG Lixian;CHEN Zhiyong;LI Junyi;LIU Chunyun(Yunnan Provincial Clinical Medical Center for Infectious Diseases,The Third People’s Hospital of Kunming,Kunming 650041,China;Department of Infectious Diseases,The First People’s Hospital of Zaoyang,Zaoyang,Hubei 430000,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2024年第2期271-277,共7页
Journal of Clinical Hepatology
基金
佑安专科联盟科研专项基金(LM202014)。
